Pembrolizumab as First-Line Treatment for Non–Small-Cell Lung Cancer?

Pembrolizumab is one of two anti–PD-1 (programmed cell death 1) antibodies that are FDA-approved as salvage therapy for non–small-cell lung cancer (NSCLC). In a manufacturer-funded, multinational, open-label trial (KEYNOTE-024), 305 adults who had untreated metastatic NSCLC, tumors with ≥50% PD-L1 (programmed death ligand 1) immunohistochemical expression and no sensitizing EGFR mutations or ALK translocations were randomized to receive pembrolizumab (200 mg intravenously every 3 weeks for 35 cycles) or investigator-chosen platinum-based chemotherapy (for 4 to 6 cycles). Patients receiving chemotherapy that included pemetrexed could continue maintenance pemetrexed. Crossover from chemotherapy to pembrolizumab was allowed if disease progress…